Diabetes Mellitus: General information

• CDC 14.7 million Americans diagnosed (2004)• Est. 5 million not diagnoses

Boston Globe – 10/27/2005

21 million Americans have diabetes, CDC says

WASHINGTON -- Almost 21 million Americans have diabetes, most of them the type-2 variety associated with poor diet, too little exercise, and being overweight, the Centers for Disease Control and Prevention said yesterday.

Boston Globe – 10/27/2005

This represents about 7 percent of the population -- and more than 6 million of these people do not know they have the condition, the CDC said in a statement.

Boston Globe – 10/27/2005

''Another 41 million people are estimated to have pre-diabetes, a condition that increases the risk of developing type-2 diabetes -- the most common form of the disease -- as well as heart disease and stroke," the CDC said

Diabetes Mellitus:

• 6th leading cause of death in US• 3rd leading cause of death by disease• Assoc. with many complication• Heart disease is the leading cause for a

diabetic• 65% of diabetics have hypertension

Diabetes Mellitus:

• Risk of heart attack or stroke 3 times great if you have DM

• DM leading cause of blindness in adults• DM leading cause of new cases of renal failure• 50% of all people with non-traumatic leg

amputation have DM

Diabetes Mellitus:

• DM shortens peoples life span• DM creates disabilities• DM is an economic burden• 12% of all health care expenditures are for

diabetic care/treatment• Seen in all age groups and races• 1/3 of diabetics are over the age of 60

What is diabetes mellitus?

• Group of disordered characterized by chronic hyperglycemia

• Due to faulty insulin production• (Not Diabetes Insipidus)

Classification of Diabetes

• Type 2– Adult onset– Non-insulin dependent diabetes mellitus (NIDDM)

• Type 4– Gestational Diabetes Mellitus

Type 1 – Diabetes Mellitus

• Old names – Juvenile diabetes– Insulin dependent diabetes mellitus (IDDM)

• Destruction of the Beta cells• Result

– NO insulin production– Insulin dependent

Etiology Type 1 DM

• #1: Auto-immune disease

• #2: Idiopathic• Genetic susceptibility

Function of Insulin

• Need insulin for glucose to cross cell membrane

• No insulin no glucose in the cell

• Glucose stays in the blood

S&S of Type 1 DM

• Hyperglycemia– ↑ blood glucose levels – No insulin – Glucose stays in the blood stream

• What effect does insulin have on glycogen?– Inhibits the conversion of glycogen to glucose

S&S of Type 1 DM

• Glycosuria– Glucose in the urine

S&S of type 1 DM

• Polyuria– Osmotic diuresis

• Nocturia– Urinating during the night

• Nursing diagnosis– Fluid Volume Deficit

S&S of Type 1 DM

• Polydipsia– Excessive thirst

S&S of Type 1 DM

• Polyphagia– Excessive hunger

S&S of Type 1 DM

• Dehydration

S&S of Type 1 DM

• Ketonuria– No insulin– Burn fats– Byproduct ketones– ↑ ketone in the blood – Metabolic Acidosis

– Liver can not excrete all of the ketones

– spill into the urine – Ketonuria

Small Group Questions

1. Why would a person with high glucose levels have polyphagia?

2. Explain why polyuria is a common symptom of diabetes Mellitus Type 1.

3. What is hyperglycemia?4. Why does hyperglycemia happen in Type 1 diabetes

mellitus?5. Explain why Ketonuria occurs in uncontrolled

diabetics.

Small Group Questions

6. What is a normal level for a FBS, 2h-PPG and GTT?

7. Define the following terms: Glucose, glycogen, glucagon, Glycogenolysis, Glycogenesis, Glycosuria.

8. What does an Hgb A1c measure? What are normal values for a diabetic and non-diabetic?